GRANT APPLICATION Guy A. and N. Kay Arboit Charitable Trust

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GRANT APPLICATION First American Bank, as trustee of the honors the Arboits charitable intentions through the making of grants that further their charitable missions. Areas of Interest The Trust s primary focus is to provide funding in the following fields: Education for the underprivileged; Cardiac and cancer medical research and programming; and Religious or religious charitable activities, particularly those related to the Catholic Church. Generally grants are restricted to organizations located in the greater Chicago metropolitan area which often have difficulty applying for and receiving similar funding from other sources. Grant Procedures We generally review grant requests at the end of May and November of each year for packages postmarked by April 15 and October 1. If your proposal is not postmarked by the deadline, it will be held and considered in the next grant cycle. An organization that has received a grant in the spring cycle or as part of a multi-year grant will not be eligible to apply for a second grant within the same calendar year. Organizations will be notified of grant funding decisions by June 15 th or December 15 th depending on which cycle the proposal was considered. Due to the number of grant proposals received, we cannot provide status of grant proposals. Every proposal received will receive a written decision letter. Only proposals received by mail will be considered. Please mail completed grant request to: GRANT PROPOSAL ENCLOSED c/o First American Bank 218 W. Main Street West Dundee, IL 60118

Amount Requested Multi-year YES NO Type of Support General Operating Capital Project Program Support Equipment Other When was the last time you submitted a grant application to this Trust? Was it denied or granted? GRANT REQUEST Organization Name EIN Address City State Zip Fax Website Executive Director Contact Person Email Address Describe your organization s mission: Service Area Chicago Chicago Suburbs - Specify: Regional/National Other

Review of the past year s activities: Highlights of your organization s activities and accomplishments during the past year. How did you find out about the trust? Disclosure of any relationship with First American Bank: List any relationship your organization has with First American Bank, or any other direct or indirect relationship that your organization, your Board of Directors, or your key staff have with First American Bank or any Director or Officer of First American Bank. Does any employee of First American Bank serve on your Board of Directors or any committees? Purpose of your request:

Need Statement: Proposed plan of action: Your timetable and how the grant will help you achieve your long range goals or proposed activities. Evaluation procedure: Details of how you propose to evaluate the results of your project. List other funding sources for this project: No need to complete if this is a request for general operating support.

Signature of Authorized Official Date Print Name Title Attachments (please provide in this order) A. Finances 1. Financial statements for the last fiscal year. 2. Current year s organizational budget. Categorize expenses under program, general and administrative, and fundraising. 3. Budget for proposed project, if applicable. 4. A list of significant donations by foundations, corporations or governmental agencies. 5. Itemization of use of requested funds. B. Other Supporting Materials 1. The latest annual report of your organization. 2. Current Board of Directors and key staff people. Include names, titles, a means of contacting each of them, as well as the salaries of all key personnel. 3. Copy of the IRS letter ruling confirming your active status as a 501(c)(3) organization. 4. Statement indicating your tax exemption identification classification, as proscribed by the IRS. 5. If you received a grant from the Trust in the past, a grant report must be included. No further grant requests from your organization will be considered until a grant report has been completed and returned.